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Detection of illness worry in the general population: A specific item on illness rumination improves the Whiteley Index

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@article{4068764ec9ab46668e87132dacdc4ccb,
title = "Detection of illness worry in the general population: A specific item on illness rumination improves the Whiteley Index",
abstract = "OBJECTIVE: The Whiteley Index (WI) is the most widely used screening tool for health anxiety/illness worry. Diverse versions (different number of items and factors) have been used. We aimed to examine psychometric properties of 7 items of the WI besides adding a new item on obsessive illness rumination for better future detection of health anxiety.METHODS: Data from a large population-based study in Denmark (N = 9656). Construct validity was examined by exploratory (EFA) and confirmatory factor analysis (CFA) plus hypothesis testing. Criterion validity was evaluated via Receiver Operating Characteristic curves and area under the curve (AUC) using a diagnostic criterion as gold standard.RESULTS: Factor loadings of EFA revealed viable one-factor models (6, 7, or 8 items) and two-factor models (7 or 8 items). Factor one indicated a dimension of illness worry. Factor two indicated a somatic symptoms dimension. The new item on obsessive illness rumination merged well with the existing items. EFA of two-factor models and one-factor 6-item model showed good fit. CFA resembles these findings. A one-factor 6-item model (including the item on obsessive illness rumination and excluding two items concerning somatic symptoms) was chosen as the optimal model and presented good criterion validity: AUC 0.88 (95{\%}CI(0.84;0.92)). Main hypotheses concerning associations with somatic symptoms, anxiety, and depression were met.CONCLUSIONS: We found good psychometric properties for a new one-factor 6-item version of the WI. Through elimination of items concerning somatic symptoms and inclusion of obsessive illness rumination, we propose a clear, unidimensional and improved measure of illness worry: Whiteley-6-R.",
author = "Carstensen, {Tina Birgitte Wisbech} and Eva {\O}rnb{\o}l and Per Fink and Pedersen, {Majbritt Mostrup} and Torben J{\o}rgensen and Dantoft, {Thomas Meinertz} and Benros, {Michael Eriksen} and Lisbeth Frostholm",
note = "Copyright {\circledC} 2020 Elsevier Inc. All rights reserved.",
year = "2020",
month = "11",
doi = "10.1016/j.jpsychores.2020.110245",
language = "English",
volume = "138",
pages = "110245",
journal = "Journal of Psychosomatic Research",
issn = "0022-3999",
publisher = "Elsevier Inc",

}

RIS

TY - JOUR

T1 - Detection of illness worry in the general population

T2 - A specific item on illness rumination improves the Whiteley Index

AU - Carstensen, Tina Birgitte Wisbech

AU - Ørnbøl, Eva

AU - Fink, Per

AU - Pedersen, Majbritt Mostrup

AU - Jørgensen, Torben

AU - Dantoft, Thomas Meinertz

AU - Benros, Michael Eriksen

AU - Frostholm, Lisbeth

N1 - Copyright © 2020 Elsevier Inc. All rights reserved.

PY - 2020/11

Y1 - 2020/11

N2 - OBJECTIVE: The Whiteley Index (WI) is the most widely used screening tool for health anxiety/illness worry. Diverse versions (different number of items and factors) have been used. We aimed to examine psychometric properties of 7 items of the WI besides adding a new item on obsessive illness rumination for better future detection of health anxiety.METHODS: Data from a large population-based study in Denmark (N = 9656). Construct validity was examined by exploratory (EFA) and confirmatory factor analysis (CFA) plus hypothesis testing. Criterion validity was evaluated via Receiver Operating Characteristic curves and area under the curve (AUC) using a diagnostic criterion as gold standard.RESULTS: Factor loadings of EFA revealed viable one-factor models (6, 7, or 8 items) and two-factor models (7 or 8 items). Factor one indicated a dimension of illness worry. Factor two indicated a somatic symptoms dimension. The new item on obsessive illness rumination merged well with the existing items. EFA of two-factor models and one-factor 6-item model showed good fit. CFA resembles these findings. A one-factor 6-item model (including the item on obsessive illness rumination and excluding two items concerning somatic symptoms) was chosen as the optimal model and presented good criterion validity: AUC 0.88 (95%CI(0.84;0.92)). Main hypotheses concerning associations with somatic symptoms, anxiety, and depression were met.CONCLUSIONS: We found good psychometric properties for a new one-factor 6-item version of the WI. Through elimination of items concerning somatic symptoms and inclusion of obsessive illness rumination, we propose a clear, unidimensional and improved measure of illness worry: Whiteley-6-R.

AB - OBJECTIVE: The Whiteley Index (WI) is the most widely used screening tool for health anxiety/illness worry. Diverse versions (different number of items and factors) have been used. We aimed to examine psychometric properties of 7 items of the WI besides adding a new item on obsessive illness rumination for better future detection of health anxiety.METHODS: Data from a large population-based study in Denmark (N = 9656). Construct validity was examined by exploratory (EFA) and confirmatory factor analysis (CFA) plus hypothesis testing. Criterion validity was evaluated via Receiver Operating Characteristic curves and area under the curve (AUC) using a diagnostic criterion as gold standard.RESULTS: Factor loadings of EFA revealed viable one-factor models (6, 7, or 8 items) and two-factor models (7 or 8 items). Factor one indicated a dimension of illness worry. Factor two indicated a somatic symptoms dimension. The new item on obsessive illness rumination merged well with the existing items. EFA of two-factor models and one-factor 6-item model showed good fit. CFA resembles these findings. A one-factor 6-item model (including the item on obsessive illness rumination and excluding two items concerning somatic symptoms) was chosen as the optimal model and presented good criterion validity: AUC 0.88 (95%CI(0.84;0.92)). Main hypotheses concerning associations with somatic symptoms, anxiety, and depression were met.CONCLUSIONS: We found good psychometric properties for a new one-factor 6-item version of the WI. Through elimination of items concerning somatic symptoms and inclusion of obsessive illness rumination, we propose a clear, unidimensional and improved measure of illness worry: Whiteley-6-R.

U2 - 10.1016/j.jpsychores.2020.110245

DO - 10.1016/j.jpsychores.2020.110245

M3 - Journal article

VL - 138

SP - 110245

JO - Journal of Psychosomatic Research

JF - Journal of Psychosomatic Research

SN - 0022-3999

ER -

ID: 60906190